Spouse or significant other's first name (as it will appear on name tag):

Spouse or significant other's last name:

Emergency Contact:

Role and Location

Select all that apply:

Board Member

Board Chair

Board Vice Chair

Sponsor Member (Leaven Ministries)

Sponsor Member Chair

SCL Health Associate (please indicate below)

Presenter or Speaker (please provide the date of your presentation(s))

SCL Health Associate Position Title:

Presenter or Speaker Date of Presentation(s):

Select all that apply:

I am a new board member since 2016

I have participated in system board orientations in 2015 or prior

I have been through the Commissioning Ceremony (ritual of commitment to the work of SCL Health) and have received the SCL Health lapel pin

N/A

On which board do you sit or at which care site ministry are you based? Select all that apply:

SCL Health Board

Leaven Ministries

Front Range Board

Mount Saint Vincent

System Services

St. James

St. Vincent

Holy Rosary

St. Mary's

Platte Valley

Lutheran

Saint Joseph

Other

If other, please specify:

Office City and State (where your primary office or board is located):

Lodging

SCL Health will make guest room reservations at the Royal Palms Resort via rooming list, based on the arrival and departure date/s indicated below.
BILLING: SCL Health will host lodging, in concurrence with the registrants’ programs, up to 3 nights for Ministry boards and presidents and up to 5 nights for System Board, Sponsor and senior leadership. All pre/ post stays and incidentals will be personal costs and a credit card will be requested at check-in.

Hotel arrival date for guest room (check in at 4 p.m.)

Monday, October 1

Tuesday, October 2

Wednesday, October 3

Thursday, October 4

Friday, October 5

Hotel departure date for guest room (check out at 12 p.m.)

Tuesday, October 2

Wednesday, October 3

Thursday, October 4

Friday, October 5

Saturday, October 6

Indicate personal nights:

Bed selections and rooms will be accommodated as able. Please select one:

King bed

Two queen beds

ADA accessible

No preference

Programs

Select the program(s) you will attend. Business programs are not open to spouses.

To assist in planning and ensure your comfort and well-being, indicate any dietary restrictions:Breakfast, lunch and dinner group meal functions at the Royal Palms, are hosted by SCL Health. Registrants and spouses will be accounted and plans made based on the information provided.

Networking Opportunities

In appreciation of the commitment of our volunteer board members, events have been planned to enable valuable networking opportunities in several different enjoyable local venues; and costs will be hosted by SCL Health. All directors, leadership and spouses are encouraged to take advantage of this offering. Box lunches will be available. Group shuttles and the Hummers will depart from the resort in intervals starting at noon and all will return by 5:30 p.m. This scheduling enables time to freshen up prior to the 6:30 p.m. Welcome Reception and dinner. Detailed information will be provided, based on selections below. In addition, the Royal Palms offers world class spa experiences and reservations are needed. Scottsdale and Phoenix abound in shopping and arts venues, and information will be available. Alvadora Spa services and local shopping adventures are personally arranged and at personal cost.

Registrant select one excursion:

Golf 18 holes at Camelback Country Club (foursome tee-times at 10 minute intervals)

Hummer desert tour in groups of 10

Native peoples and desert plant guided museum tour in Old Scottsdale

No thank you

Spouse select one excursion:

Golf 18 holes at Camelback Country Club (foursome tee-times at 10 minute intervals)

SCL Health is an equal opportunity employer. All recruiting, training, and employment decisions are made in accordance with applicable federal, state, and local laws and without regard to race, color, ancestry, national origin, gender, pregnancy, gender identity, sexual orientation, religion, age, disability, handicap, military or veteran status, or any other legally protected status.

NOTICE OF NONDISCRIMINATION

Our facilities do not discriminate against any person on the basis of race, color, national origin, disability, or age in admission or access to, or treatment or employment in, its programs, services or activities, or on the basis of sex (gender) in health programs and activities. Read the full notice: